Epidemiology

Notable in the epidemiology of carcinoma of the pancreas is that:

• pancreatic carcinomas are principally adenocarcinomas (over 80%); rarely, they are a result of endocrine cell neoplasia, for example, insulinoma, glucagonoma (1)
• mainly affects the elderly, being rare before 50 years of age (1)
• men are affected more often than women, in the ratio 3:2 (1)
• third most common cancer of the gastrointestinal tract, behind that of bowel and stomach (1)
• estimated 279,000 cases of pancreatic cancer were diagnosed worldwide in 2008.
  • highest incidence was reported in North America and Europe (particularly high rates in males in Central and Eastern Europe)
  • lowest incidence rates are found in Asia and Africa (2)
• accounts for 5% of all cancer deaths (1)
• incidence seems to have increased in the last two decades possibly as a result of better diagnosis and also a real rise in frequency
• pancreatic cancer has the worst survival rate of all cancers
  • 5-year survival is only 3%.
  • relative survival to 1 year is less than 20% and is one of the worst rates in Europe
  • 82% of people diagnosed with pancreatic cancer in the UK will die within a year as most are diagnosed with late stage disease
  • 47% of people are diagnosed as an emergency in our A&E departments (4)
  • only 10% of patients are diagnosed in time for potentially curative surgery (5)
  • those who are diagnosed in time for surgery have a 30% chance of surviving five years (5)

In UK

• pancreatic cancer is the 10th most common cancer in the UK (2010), accounting for 3% of all new cases.
  • in males, it is the 12th most common cancer (3% of the male total), and the 8th in females (3%) (2)
• in 2010, 8463 people were newly diagnosed with pancreatic cancer in the UK
• male:female ratio of almost 1:1
• in 2009, 8047 people died from pancreatic cancer in the UK
• 22 people a day die from pancreatic cancer (3)
• in the UK between 2008 and 2010, an average of around 75% of cases were diagnosed in men and women aged 65 years and over, and 96% of cases were diagnosed in those aged 50 years and over
• deaths from pancreatic cancer increased between 2002 & 2009 while deaths from many other cancers declined (3)

Reference:

• (1) Referral Guidelines for Suspected Cancer (April 2000). NHS Executive.
• (2) Cancer research UK. Pancreatic cancer incidence
• (3) based on 2009 UK mortality figures (from http://pancreaticcanceraction.org/facts-figures/quick-statistics/)
• (4) NCIN (2010)
• (5) White et al., (1999) in Sultana et al.Systematic review, including meta-analysis, on the management of locally advanced pancreatic cancer using radiation/combined modal therapy. British Journal of Cancer 2007; 96:1183-1190